Clinical implications of frailty in peritoneal dialysis patients – A prospective observational study
Background: Frailty is an age-related condition that predicts adverse outcomes. The study was aimed to investigate the clinical implications of frailty evolution in patients undergoing peritoneal dialysis (PD). Method: In this prospective study, all new-onset (<6 months) and prevalent (≧6 months)...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-02-01
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| Series: | Journal of the Formosan Medical Association |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664623002619 |
| _version_ | 1797292963440623616 |
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| author | Yi-Ting Chen Tai-Shuan Lai Hsiao-Mei Tsao Chun-Fu Lai Shao-Yo Yang Yung-Ming Chen |
| author_facet | Yi-Ting Chen Tai-Shuan Lai Hsiao-Mei Tsao Chun-Fu Lai Shao-Yo Yang Yung-Ming Chen |
| author_sort | Yi-Ting Chen |
| collection | DOAJ |
| description | Background: Frailty is an age-related condition that predicts adverse outcomes. The study was aimed to investigate the clinical implications of frailty evolution in patients undergoing peritoneal dialysis (PD). Method: In this prospective study, all new-onset (<6 months) and prevalent (≧6 months) PD patients completed frailty assessment at entry and 6 months by a semiautomated frailty index of 80 risk factors (FI80) which also contained the 5 components of Fried frailty phenotype. A score ≧13/80 (FI80 > 0.16) or ≧3/5 (frailty phenotype) was designated to define frailty. Result: 337 PD patients were recruited (new-onset 23.4%, prevalent 76.6%). Two hundred (59.3%) and 163 (48.4%) patients were frail by FI80 and frailty phenotype, respectively. Predictors for frailty were old age, dialysis, diabetes mellitus, gout and sleep disorder. New-onset patients aged <55 years displayed the best evolution of frailty over 6 months (stable or improved, n = 29/47, 61.7% by FI80, p = 0.0293), compared with other groups. Survival analysis found that frail patients exhibited the worse outcomes (overall death and hospitalization). Poisson regression showed frailty was associated with increased utilizations of outpatient and ER services; however multivariate Cox models identified only diabetes, gout and low body mass index (<19 kg/m2), but not frailty, predicted overall death and hospitalizations. Conclusion: Frailty is a common medical condition in PD patients, and the status of which can be stabilized or improved in new-onset, young patients at least over the short term. Compared with frailty, certain comorbidities (diabetes and gout) and undernutrition appeared to be more robust in the prediction of adverse outcomes. |
| first_indexed | 2024-03-07T20:05:03Z |
| format | Article |
| id | doaj.art-66f019b301cc4ebeb1aecab149ce3233 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-03-07T20:05:03Z |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-66f019b301cc4ebeb1aecab149ce32332024-02-28T05:12:47ZengElsevierJournal of the Formosan Medical Association0929-66462024-02-011232248256Clinical implications of frailty in peritoneal dialysis patients – A prospective observational studyYi-Ting Chen0Tai-Shuan Lai1Hsiao-Mei Tsao2Chun-Fu Lai3Shao-Yo Yang4Yung-Ming Chen5Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Division of Blood Purification, Department of Integrated Diagnostics & Therapeutics, National Taiwan University Hospital, Taipei, TaiwanDivision of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, TaiwanDivision of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, TaiwanDivision of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanDivision of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanDivision of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan; Corresponding author. Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, No. 7, Zhong-Shan South Road, Taipei, Taiwan.Background: Frailty is an age-related condition that predicts adverse outcomes. The study was aimed to investigate the clinical implications of frailty evolution in patients undergoing peritoneal dialysis (PD). Method: In this prospective study, all new-onset (<6 months) and prevalent (≧6 months) PD patients completed frailty assessment at entry and 6 months by a semiautomated frailty index of 80 risk factors (FI80) which also contained the 5 components of Fried frailty phenotype. A score ≧13/80 (FI80 > 0.16) or ≧3/5 (frailty phenotype) was designated to define frailty. Result: 337 PD patients were recruited (new-onset 23.4%, prevalent 76.6%). Two hundred (59.3%) and 163 (48.4%) patients were frail by FI80 and frailty phenotype, respectively. Predictors for frailty were old age, dialysis, diabetes mellitus, gout and sleep disorder. New-onset patients aged <55 years displayed the best evolution of frailty over 6 months (stable or improved, n = 29/47, 61.7% by FI80, p = 0.0293), compared with other groups. Survival analysis found that frail patients exhibited the worse outcomes (overall death and hospitalization). Poisson regression showed frailty was associated with increased utilizations of outpatient and ER services; however multivariate Cox models identified only diabetes, gout and low body mass index (<19 kg/m2), but not frailty, predicted overall death and hospitalizations. Conclusion: Frailty is a common medical condition in PD patients, and the status of which can be stabilized or improved in new-onset, young patients at least over the short term. Compared with frailty, certain comorbidities (diabetes and gout) and undernutrition appeared to be more robust in the prediction of adverse outcomes.http://www.sciencedirect.com/science/article/pii/S0929664623002619FrailtyFried frailty phenotypeDeficit-accumulation frailty indexPeritoneal dialysis |
| spellingShingle | Yi-Ting Chen Tai-Shuan Lai Hsiao-Mei Tsao Chun-Fu Lai Shao-Yo Yang Yung-Ming Chen Clinical implications of frailty in peritoneal dialysis patients – A prospective observational study Journal of the Formosan Medical Association Frailty Fried frailty phenotype Deficit-accumulation frailty index Peritoneal dialysis |
| title | Clinical implications of frailty in peritoneal dialysis patients – A prospective observational study |
| title_full | Clinical implications of frailty in peritoneal dialysis patients – A prospective observational study |
| title_fullStr | Clinical implications of frailty in peritoneal dialysis patients – A prospective observational study |
| title_full_unstemmed | Clinical implications of frailty in peritoneal dialysis patients – A prospective observational study |
| title_short | Clinical implications of frailty in peritoneal dialysis patients – A prospective observational study |
| title_sort | clinical implications of frailty in peritoneal dialysis patients a prospective observational study |
| topic | Frailty Fried frailty phenotype Deficit-accumulation frailty index Peritoneal dialysis |
| url | http://www.sciencedirect.com/science/article/pii/S0929664623002619 |
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